SHIF HEALTH COVERAGE

JOY SITATI

While the online public participation kicked off on Monday, members of the public will from tomorrow get a chance to interact with the proposed social healthcare insurance regulations, that are aimed at making operational the social health insurance act of 2023.

The act brings to life three funds that will cater for the healthcare needs of the public registered  as members of the social health fund. The primary health care fund will offer services at the dispensaries and health centres across the country. Members will be able to access both outpatient and inpatient services in the areas: promotive, preventive, curative, rehabilitative, palliative and referral services. This will include:

-Consultation, diagnosis and treatment

-Screening for diseases

-Mental and behavioral conditions management

-Last expense services that include preparation of bodies in the mortuaries

The social health care insurance fund on the other hand ,will cater for services offered on referral from the lower health facilities. The health facilities from Level four to Level six will accord members services like:

-Surgical  procedures including transplants & implants

-Screening of non communicable diseases

-Palliative, critical care

-Cancer management including radiotherapy cost of upto 25 sessions and chemotherapy costs of upto 10 sessions.

Those members who will find themselves facing health emergencies or suffering from chronic illnesses will benefit from coverage under the emergency  chronic and critical illness fund, that will amongst other things provide treatment of diseases like:

-Type 2 diabetes

-End stage kidney disease which will see patients receive three dialysis sessions per unit for one year as well as cardiac and pulmonary conditions, trauma and shock.

-They will also be qualified to use ambulance services incase of emergencies

The funds will also provide for treatment outside the country in case the treatment needed is not available locally.